ProdigyRx: A New Workers’ Comp PBM That Delivers Transparency

Austin, TX (WorkersCompensation.com) - For years, workers’ compensation payers have complained about pharmacy benefit managers’ obscure pricing methodologies and their lack of transparency and useful reports.

ProdigyRx was created to solve their problems.

“There is regulatory and market pressure on PBMs to be more transparent,” said Del Doherty, co-founder of Prodigy. A PharmD with a second doctorate in Pharmacoeconomics and with master’s degrees in public health and business, Doherty has worked with PBMs in group health and workers’ compensation for most of his 15-plus year career.

“To us, transparency means presenting clients with simplified and clear drug pricing and complete, unfiltered access to data and information,” he said.

Pass-through pricing, utilization management, and a suite of evidence-based clinical tools are among its offerings. Developed and delivered by a team of PharmDs and other clinicians, services include medication therapy management, drug utilization review, compound and specialty drug utilization controls, pharmacogenomic drug oversight, and a powerful opioid minimization program.

“PBMs should put patients first and deliver access to services with empathy and efficiency,” said Prodigy President and Co-founder Matthew Imes. “At the same time, they need to give control to payers so they pay the lowest net cost for medication, eliminate waste, and can improve clinical and return-to-work outcomes.”

Prodigy’s technology proactively integrates health management strategies to improve patient health and control costs while managing the plethora of state and federal regulations and complex disease regimens. Its databases are configured to conduct advanced financial modeling and predictive modeling so payers can better understand their pharmacy programs, improve patient outcomes, and pay the lowest net cost.

“Payers receive a streamlined, frictionless, scalable pharmacy program with unmatched technology,” Imes added. Imes has more than 30 years’ experience in the claims and vendor sides of the workers’ compensation industry. He was a co-founder of Adva-Net, which was ranked as the fastest growing healthcare company on the Inc. 500 list in 2017.                         

About ProdigyRx

Based in Austin, Texas, ProdigyRx was founded in 2020 to bring pharmacy pricing transparency to workers’ compensation insurers, third-party administrators, and self-insured/administered employers across the United States. Pass-through pricing, proactive clinical controls, and a suite of evidence-based clinical tools are among its offerings. For more information, please see https://prodigyrx.com/ or call (713) 322-6667.

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